Should be getting my medical back....but...

[Greg]

Looking for some advise here. I have been sitting on the sidelines
for about a year now after discovering that I have sleep apnea. I
never failed the failed the medical, but just didn't go in for the
test because I has not treated my condition. Now I have and I've
never felt better!

The question is...what exactly do I need to get my medical. I have
been to the AOPA web site and I can't figure out if I need a MWT test
ot not.

Link here for aopa members: http://www.aopa.org/members/pic/medical/
certification/sleep/apnea_specs.html

In paragraph 1 it says maybe not. It paragraph 2 it says every year
for the rest of your life! Anyone have recent experience with this?

[Ron Rosenfeld]

On 27 Jan 2007 06:27:12 -0800, "Greg" > wrote:

>Looking for some advise here. I have been sitting on the sidelines
>for about a year now after discovering that I have sleep apnea. I
>never failed the failed the medical, but just didn't go in for the
>test because I has not treated my condition. Now I have and I've
>never felt better!
>
>The question is...what exactly do I need to get my medical. I have
>been to the AOPA web site and I can't figure out if I need a MWT test
>ot not.
>
>Link here for aopa members: http://www.aopa.org/members/pic/medical/
>certification/sleep/apnea_specs.html
>
> In paragraph 1 it says maybe not. It paragraph 2 it says every year
>for the rest of your life! Anyone have recent experience with this?

You need one MWT for sure. Subsequent requirements would seem to depend on
the nature of your treatment.
--ron

[Greg]

You need one MWT for sure. Subsequent requirements would seem to
depend on
> the nature of your treatment.
> --ron

Are you speaking from experience? I have heard second hand stories of
people not being required to take even one MWT, but never first
hand...

Anyone?

[Mxsmanic]

Ron Rosenfeld writes:

> You need one MWT for sure. Subsequent requirements would seem to depend on
> the nature of your treatment.

Why does the FAA care about sleep apnea? It only occurs when you're
asleep--which presumably you won't be while in the cockpit.

--
Transpose mxsmanic and gmail to reach me by e-mail.

[601XL Builder]

Mxsmanic wrote:
> Ron Rosenfeld writes:
>
>> You need one MWT for sure. Subsequent requirements would seem to depend on
>> the nature of your treatment.
>
> Why does the FAA care about sleep apnea? It only occurs when you're
> asleep--which presumably you won't be while in the cockpit.
>

From WebMD

Excessive daytime sleepiness, which is falling asleep when you normally
should not, such as while you are eating, talking, or driving.

[Mxsmanic]

601XL Builder writes:

> Excessive daytime sleepiness, which is falling asleep when you normally
> should not, such as while you are eating, talking, or driving.

Ah, point taken.

The most common cause of sleepiness, though, is a lack of sleep, and
unfortunately a great many people sleep less than they should, and
tend to doze off easily in consequence. I don't know that the FAA
takes this into account (or even how it could), but some cross-country
flights must surely be powerfully sedative in effect.

Does the FAA allow pilots to carry No-Doz in the cockpit?

--
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[Mortimer Schnerd, RN[_2_]]

Greg wrote:
> Are you speaking from experience? I have heard second hand stories of
> people not being required to take even one MWT, but never first
> hand...
>
> Anyone?

I never took a MWT... don't even know what one is. I was treated for sleep
apnea some years ago; had a sleep study where they said I desatted into the 50s
(no wonder I always felt tired)... used CPAP at night for some years with very
good effect. I ended up having a gastric bypass, lost a bunch of weight and
came off all meds and the CPAP.

When I went to get my flight physical back (earlier yanked for some EKG
irregularity later proven to be bogus by a heart cath), I just provided all the
progress notes provided by the cardiologist attesting to the false positive, and
notes from my primary care physician stating I was no longer being treated for
diabetes, hypertension or sleep apnea. I never heard another word from the FAA
but I walked out of the AME's office with a third class in my hot little hand.



--
Mortimer Schnerd, RN
mschnerdatcarolina.rr.com

[Greg]

On Jan 27, 5:27 pm, "Mortimer Schnerd, RN" <mschnerdatcarolina.rr.com>
wrote:

>
I just provided all the
> progress notes provided by the cardiologist attesting to the false positive, and
> notes from my primary care physician stating I was no longer being treated for
> diabetes, hypertension or sleep apnea.
>
> --
> Mortimer Schnerd, RN
> mschnerdatcarolina.rr.com

This sounds a little different than my situation as I still have sleep
apnea (but I am being treated successfully) and sound like you no
longer have the disease at all...that's great for you but I am not so
lucky!

[Mxsmanic]

Greg writes:

> This sounds a little different than my situation as I still have sleep
> apnea (but I am being treated successfully) and sound like you no
> longer have the disease at all...that's great for you but I am not so
> lucky!

Sleep apnea is often a consequence of obesity; when it is, losing
weight usually makes it go away permanently (unless the patient gains
weight again). Obstructive apnea from other causes may be more
refractory.

--
Transpose mxsmanic and gmail to reach me by e-mail.

[Ron Rosenfeld]

On 27 Jan 2007 10:48:07 -0800, "Greg" > wrote:

>You need one MWT for sure. Subsequent requirements would seem to
>depend on
>> the nature of your treatment.
>> --ron
>
>Are you speaking from experience? I have heard second hand stories of
>people not being required to take even one MWT, but never first
>hand...
>
>Anyone?

No, I'm only reading what is on the AOPA web site. It's been years since
I've been involved with examining pilots -- and then it would have been
only for cardiovascular issues. Perhaps my background made it easier for
me to understand what is on the AOPA web site.

If you want a definitive answer and are not happy with the AOPA
information, I would suggest you contact either your own AME or one of the
Regional FAA Flight Surgeons.

Policies change from time to time, and what may have been true in the past
is not necessarily true today. Personally, I've experienced a few changes
with regard to my low pressure open angle glaucoma in terms of required
followup and duration of the medical.
--ron

[Greg]

Mortimer, I just read the AOPA site again, It says that weight loss
is not an acceptable treatment for sleep apnea. How did you get away
with that one?


On Jan 27, 5:27 pm, "Mortimer Schnerd, RN" <mschnerdatcarolina.rr.com>
wrote:
> Greg wrote:
> > Are you speaking from experience? I have heard second hand stories of
> > people not being required to take even one MWT, but never first
> > hand...
>
> > Anyone?I never took a MWT... don't even know what one is. I was treated for sleep
> apnea some years ago; had a sleep study where they said I desatted into the 50s
> (no wonder I always felt tired)... used CPAP at night for some years with very
> good effect. I ended up having a gastric bypass, lost a bunch of weight and
> came off all meds and the CPAP.
>
> When I went to get my flight physical back (earlier yanked for some EKG
> irregularity later proven to be bogus by a heart cath), I just provided all the
> progress notes provided by the cardiologist attesting to the false positive, and
> notes from my primary care physician stating I was no longer being treated for
> diabetes, hypertension or sleep apnea. I never heard another word from the FAA
> but I walked out of the AME's office with a third class in my hot little hand.
>
> --
> Mortimer Schnerd, RN
> mschnerdatcarolina.rr.com

[Greg]

> Policies change from time to time, and what may have been true in the past
> is not necessarily true today. Personally, I've experienced a few changes
> with regard to my low pressure open angle glaucoma in terms of required
> followup and duration of the medical.
> --ron

Thanks for the info. Things do change. The more I talk about this
the more I think I just need to doctor shop for an ME with a more
liberal attitude towards this situation. Sounds like some want the
MWT every year and others, like Mortimer, never had one.

[Mxsmanic]

Greg writes:

> Mortimer, I just read the AOPA site again, It says that weight loss
> is not an acceptable treatment for sleep apnea. How did you get away
> with that one?

Reading the FAA's own site indicates that all they care about is proof
that the sleep apnea is cured or no longer clinically apparent. How
that is achieved is irrelevant, unless it involves a continuing
program of medication (but that wouldn't be the case for apnea).

I note that each time someone says something about this or that being
disqualifying, a look at the actual FAA texts reveals that the reality
is more liberal, and apparently depends a lot on the examiner's and
the FAA's interpretation of individual cases.

I still think it's all too draconian, though. Riding a motorcycle is
just as dangerous as being a GA pilot, but I don't see the same
extreme medical requirements for motorcycle riders.

--
Transpose mxsmanic and gmail to reach me by e-mail.

[Greg]

>
> I note that each time someone says something about this or that being
> disqualifying, a look at the actual FAA texts reveals that the reality
> is more liberal, and apparently depends a lot on the examiner's and
> the FAA's interpretation of individual cases.


It is interesting to note that what the FAA describes as the process
doesn't seem to me what has happened to anyone I've talked to. about
this. Furthermore where does the AOPA get their information? It
seems to contradict the info on the FAA site. This is why I was
looking for as many recent real world experiences as possible. If I
am reading correctly on the FAA site my certificate decision must be
deferred to the RFS. Am I reading this correctly? I'd like to know
how long this might take as I need to make arrangement to get back
into a flying club. It will be 3 weeks before I can go to the ME with
the required documentation.

>From the FAA site...

An FAA physician provides the initial certification decision and
grants the Authorization in accordance with 14 CFR § 67.401. The
Authorization letter is accompanied by attachments that specify the
information that treating physician(s) must provide for the re-
issuance determination. If this is a first time issuance of an
Authorization for the above disease/condition, and the applicant has
all of the requisite medical information necessary for a
determination, the Examiner must defer and submit all of the
documentation to the AMCD or RFS for the initial determination.

[Mortimer Schnerd, RN[_2_]]

Greg wrote:
> Mortimer, I just read the AOPA site again, It says that weight loss
> is not an acceptable treatment for sleep apnea. How did you get away
> with that one?


I don't know. I don't have sleep apnea any more. I'm told I snore loudly at
times but I don't stop breathing. I don't fall asleep during the day. Anyway,
my medical history is quite involved and it might have gotten lost in the
details. I'm not inclined to bring it up.

Maybe the FAA feels guilty for screwing me out of 15 years of flying because of
their unreasonable requirements. Back in 1990, I was asked to submit to a
cardiac stress test because of something they saw on my EKG in Oklahoma City.
Nobody here saw anything wrong with my EKG. But pleading did no good. I didn't
have the money for the test... I was working as a cargo pilot and was living
hand to mouth. I just walked away from the industry and went to nursing school
instead.

To make a long story short, I was being worked up for surgery in 2003 and had
another EKG. This one was abnormal and suggested I'd had a heart attack
sometime in the past. (You'd think I'd have noticed something like that.) That
led to a stress test (TA DA!!!!), this time paid for by my HMO. That led to a
heart cath where the cardiologist pronounced my coronary arteries completely
clear.

I've been a multi trauma and have had (I think) 18 surgeries... mostly fixing
fractures with hardware, I&Ds (cleanups), multiple skin and bone grafts, a hip
replacement and a gastric bypass. I was being treated for the sleep apnea,
hypertension, and non-insulin dependent diabetes.

Screw 'em.... I walk without a limp, take no meds for anything, and I'm back
flying again. I'll never do it for a living again since I've found a more
lucrative line of work but I do get to go every so often.

I think I just beat them down.


--
Mortimer Schnerd, RN
mschnerdatcarolina.rr.com

[Montblack]

("601XL Builder" wrote)
> From WebMD
>
> Excessive daytime sleepiness, which is falling asleep when you normally
> should not, such as while you are eating, talking, or driving.


http://en.wikipedia.org/wiki/Modafinil
Also used as a "smart drug."

http://www.modafinil.com/
"Modafinil is increasingly used as a 'lifestyle drug' - a lucrative
'off-label' market its makers have not been unduly keen to discourage. Some
prescribing physicians have reportedly been surprised at a previously hidden
epidemic of narcolepsy among hard-working young professionals..." <g>


Montblack